Ultrafiltration and endotoxin removal from dialysis fluids

Kidney Int Suppl. 1993 Jun:41:S201-4.

Abstract

Biocompatibility in hemodialysis is now regarded as a multifactorial problem and dialysate represents a main risk. Pyrogenic fractions mostly coming from gram-negative bacteria easily pass through dialysis membrane, either by backdiffusion or by backfiltration, and induce blood cell activation. To demonstrate the long-term efficiency of a 2 m2 polyamide ultrafilter in producing a pyrogen free solution, we used an experimental circuit ultrafiltering for 240 hours (500 ml/min) a bicarbonate dialysate contaminated (5 to 48 EU/ml) by a Pseudomonas aeruginosa filtrate. The efficiency was monitored by LAL-test and IL-1 PBMC so to detect not only lipid A containing endotoxins but also other cytokines inducing bacterial fractions. At the post-ultrafilter sampling port the LAL-test was < 0.005 to 0.034 EU/ml; IL-1 PBMC was below the detection limit (20 pg/ml) being 27 to 63 pg/ml at the pre-ultrafilter level. Polyamide ultrafiltration represents an efficient system to obtain an endotoxin-free dialysate and a single filter works up to 240 hours.

MeSH terms

  • Cells, Cultured
  • Drug Contamination
  • Endotoxins / isolation & purification*
  • Hemodialysis Solutions*
  • Humans
  • Interleukin-1 / biosynthesis
  • Leukocytes, Mononuclear / metabolism
  • Membranes, Artificial*
  • Molecular Weight
  • Pyrogens / isolation & purification
  • Renal Dialysis*
  • Ultrafiltration

Substances

  • Endotoxins
  • Hemodialysis Solutions
  • Interleukin-1
  • Membranes, Artificial
  • Pyrogens